I remember it well, catching up with former classmates at continuing education events about a year after graduation. Hugs and smiles. We’re both doing well. We’re both learning a lot. We’re seeing pretty much all trauma all day long. Then, I say in one form or another that most of what I’ve been doing with clients generally falls under CBT, including the mindfulness stuff.
That’s where things fall off a cliff. From the look on her face, I might as well have said that I was sleeping with clients. Or, that I was rebirthing clients through a tightly bound mattresses. I’m reasonably good at reading emotions and the emotion looked a lot like disgust. This happened several times over a six month period with various people that I was initially delighted to see.
Now, I’m afraid I’m that person. EMDR training, practice, and receiving my own EMDR therapy has changed me. I’m careful to check my tone when speaking to other therapists about my love of EMDR. Still, I find myself saying things like:
“EMDR changes everything.”
“Before EMDR, things were like the horse and buggy era. Now it’s the era of modern jet aircraft.”
“More healing happens in one good EMDR reprocessing session than happened in 50 of our best CBT sessions.”
“Trauma Focused CBT has the real potential to severely retraumatize already traumatized clients.”
“If you work in community mental health, you’re already a trauma therapist. You don’t have the luxury of just being a generalist, when every client all day long is traumatized. We all need more training in trauma work. If we don’t see and treat trauma, then why are we even here?”
“I have clients who have been in counseling all of their lives that I will be discharging or stepping down soon because of their great work with EMDR.”
I’m aware that these statements sound pretty arrogant. Yet, I have come to fully believe them. I’m working to find language to communicate my excitement about EMDR in ways that might be received better. I want to be a gentle evangelist, because I remember how deeply that implicit or explicit judgement stings. I delayed getting trained in mindfulness-related topics because of that judgement and I carried a lot of self-consciousness into my initial EMDR training weekend. “Feeling like my approach to therapy disgusts my friends” was one of my targets as the “client” during the practicum portion of my initial EMDR training weekend. Repeat the irony: I felt so judged by some of mindfulness oriented colleagues that I targeted that judgement during my own EMDR therapy training. Fortunately it worked beautifully and helped create enough space for me to come to see EMDR as a way of accomplishing CBT’s goals more effectively.
At the center of the EMDR/CBT divide is a core difference in how trauma is conceptualized. For EMDR, trauma is stored as unprocessed and unintegrated memories. The problem results from overwhelmingly negative events that have happened to the client. Treatment focuses on helping the client reprocess those “stuck” memories in a more adaptive way. For CBT, traumatic experiences result in thought distortions. The problem is how the client thinks about what has happened to him. It focuses on exposures and correcting “incorrect” thoughts. EMDR therapists believe that trauma is stored deeply in the emotional brain, beneath thoughts and language. Many EMDR therapists believe that CBT, with its focus on “distortions,” implicitly or explicitly blames clients for their resulting trauma symptoms. Many EMDR therapists believe that the language and approach of CBT for trauma can be retraumatizing. Fortunately, the “thought distortions” of CBT clear up quickly and seamlessly during reprocessing using EMDR. So, I now see EMDR as a faster, gentler, and more comprehensive way of accomplishing the goals of CBT (and much more). Someone might have explained this to me.
Having done my own EMDR work (as a client) and conducted hundreds of EMDR sessions (as the therapist), I have had a front-row seat to the astonishing capacity of the mind and body to quickly and seamlessly reconcile horrible experiences. Realizing that this capacity is inside all us makes everything horrible feel a little less so. Coming to see the power of EMDR feels like a spiritual, cognitive, and somatic conversion for me. And I want to tell this great news to every therapist I know and do so without sounding like a righteous jerk. Humility is at the core of EMDR. There is nothing for the therapist to create or own. It’s all already there inside each of us. I’m sure I can do better at communicating this. I’m sure that we all can.